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What’s bad for the gander . . . Women and sudden cardiac death
  1. W J Groh,
  2. E von der Lohe,
  3. D P Zipes
  1. Department of Medicine, Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana, USA
  1. Correspondence to:
    William J Groh, MD, Krannert Institute of Cardiology, Indiana University School of Medicine, 1800 North Capitol, Indianapolis, IN 46202, USA;

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The risk of sudden cardiac death seems to be increasing in women, such that the two sexes may soon reach parity when it comes to SCD

Sudden cardiac death (SCD), typically defined as death from a cardiac cause that occurs within one hour of the onset of symptoms in an individual without a prior condition that would appear fatal, remains a major health problem in the developed world.1 SCD accounts for more than 60% of all cardiac deaths, with absolute numbers in the USA well in excess of 400 000 annually.2 The majority of SCD occur in the setting of coronary heart disease (CHD) and thus populations with this condition often form the basis for SCD risk assessment.3

A truism regarding SCD in the setting of CHD has been that women are at a significantly lower risk than men. In the Rochester CHD project women presenting with angina, despite being an average of seven years older than men presenting with angina, had only half the risk of dying in the subsequent 10 years as men.4 In the Framingham study cohort with outcome data ascertained over almost four decades, women with CHD had a quarter of the risk of SCD as men.5 In those with documented myocardial infarction, the age adjusted annual rate of SCD was 4.6 per 1000 in women and 17.5 …

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